Differential diagnosis of bilateral lungs opacities in the hospital for admission of community-acquired pneumonia – not only COVID-19

Due to the current epidemiological situation caused by the spread of the new SARS-CoV-2 coronavirus, in March 2020 several Moscow hospitals were completely or partially redesigned to receive patients with community- acquired pneumonia.

Purpose. The aim of the survey is to analyze clinical, laboratory and radiological data in patients with coronavirus infection at the early stages of its spread in Russia, and to clarify diseases for differential diagnosis mainly based on CT evidence.

Materials and methods. We studied data from 21 patients with verified coronavirus infection admitted to the hospital for community-acquired pneumonia. Clinical symptoms, laboratory and physical indicators, as well as typical lung changes on the CT were evaluated.

Results. Major clinical symptoms in coronavirus patients are fever (100%), cough (90.5%), shortness of breath (76.1%). Laboratory indicators showed increases in CRP (85.7%), leukocytosis (66.6%), and LDG (84.6%). According to CT, 95.2% of lung changes involved both sides, and 66.7% occurred in all lung fields. The sign of “ground glass” was observed in a 100% of the cases, its combination with the “paving stone” – in 61,9%, “ground glass” coupled with small areas of consolidations were detected in 33,3% of the cases. Changes such as nodules, cavities and massive areas of consolidation were not identified.

Conclusion. On the basis of our own data we confirmed the main trends of diagnostics and clinical features, which were identified by authors from Asia and Europe, who faced this infection earlier, and also considered important CT characteristics useful for differential diagnosis of coronavirus lung damage and other lung diseases.

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